Hepatopancreatoduodenectomy for advanced hepatobiliary malignancies: a single-center experience

Hepatobiliary Pancreat Dis Int. 2017 Aug 15;16(4):382-386. doi: 10.1016/S1499-3872(17)60039-0.

Abstract

Background: Hepatopancreatoduodenectomy is a complicated and challenging procedure but necessary for curative resection for advanced hepatobiliary malignancies. This retrospective study was to examine the safety and survival outcomes of hepatopancreatoduodenectomy in our center.

Methods: Prospectively collected data of 12 patients who underwent hepatopancreatoduodenectomy for advanced hepatobiliary malignancies in our hospital from January 1998 to December 2014 were analyzed. The primary endpoints are treatment-related morbidity and mortality and the secondary endpoints are overall survival and disease-free survival.

Results: Curative resection was achieved in 11 (91.7%) patients. Complications developed in 10 (83.3%) patients. Three hospital deaths resulted from multiorgan failure secondary to postoperative pancreatic fistula or hepaticojejunostomy leakage. Six of the nine remaining patients had disease recurrence. The nine patients had a median survival of 39.8 (5.3-151.8) months. The 1-, 3- and 5-year overall survival rates were 66.7%, 55.6% and 27.8%, respectively. The corresponding disease-free survival rates were 55.6%, 44.4% and 29.6%, respectively.

Conclusions: Morbidity and mortality after hepatopancreatoduodenectomy were significant. With R0 resection, the 5-year overall survival and disease-free survival rates were 27.8% and 29.6%, respectively.

Keywords: hepatectomy; hepatopancreatoduodenectomy; malignancy; pancreaticojejunostomy; pancreatoduodenectomy.

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Hepatectomy / mortality
  • Hong Kong
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / methods*
  • Pancreaticoduodenectomy / mortality
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome